Review Article
Noninvasive Biomarkers of Gut Barrier Function in Patients Suffering from Diarrhea Predominant-IBS: An Update
Table 1
Noninvasive methods for assessment of intestinal barrier integrity and function.
| | Probe | Test site | Method | Indicative for | Samples | Advantages | Limitations |
| | I-FABP | Small intestine | ELISA | Epithelial integrity | Blood/urine | Region-specific | Acute phase | | TJ proteins | Whole intestine | Western blot analysis | Epithelial integrity | Urine | Detection of TJ loss without tissue sections | Nonspecific for gut | | DAO | Small intestine | ELISA/enzymatic spectrophotometry | Epithelial integrity | Blood | Marker of maturation and integrity | Limited data | | 51Cr-EDTA | Whole intestine | Gamma counter | Epithelial function | Urine | Easy detection, not naturally present | Radioactivity, single probe | | PEG | Whole intestine | HPLC, LC-MS | Epithelial function | Urine | Not metabolized by enzymes or degraded by bacteria within the human GI tract | Laborious detection | | La/Ma | Small intestine | HPAEC-PAD/LC-MS | Epithelial function | Urine | Combination in multisugar tests, widely used | Time-consuming | | Sucrose | Stomach-duodenum | HPAEC-PAD/LC-MS | Epithelial function | Urine | Specific for stomach | Time-consuming, degraded by sucrase in the duodenum | | Sucralose | Whole intestine | HPAEC-PAD/LC-MS | Epithelial function | Urine | Resistive to bacterial degradation | Time-consuming, long collection time | | Zonulin | Whole intestine | ELISA | Epithelial function | Blood/feces | Specific for the small intestine, correlation with IP | Low ELISA specificity for detection | | D-lactate | Whole intestine | ELISA/enzymatic spectrophotometry | Epithelial integrity | Blood | Easy detection | Limited data in humans |
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I-FABP: intestinal fatty acid-binding protein; TJs: tight junctions; DAO: diamine oxidase; 51Cr-EDTA: 51Chromium-labeled Ethylene Diamine Tetra-acetic Acid; PEG: polyethylene glycols; La/Ma: lactulose to mannitol; ELISA: enzyme-linked immunosorbent assay; HPLC: high-performance liquid chromatography; LC-MS: liquid chromatography-mass spectrometry; HPAEC-PAD/LC-MS: high-performance anion-exchange chromatography with pulsed amperometric detection.
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